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At least 271 records · Page 15Linked to original sources
PubMed1992

Geriatric patient emergency visits. Part I: Comparison of visits by geriatric and younger patients.

OBJECTIVES: To describe emergency department use by the elderly, to define problems associated with emergency care of the elderly, and to compare these results with those for younger adult patients. DESIGN: Retrospective, controlled chart review. SETTING: Six geographically distinct US hospital EDs. PARTICIPANTS: From each site, a stratified sample (approximately 7:3) of elderly (65 years or older) and nonelderly (21 to 64 years old) control patients treated during the same time period was used. METHODS: Standardized review of ED records and billing charges. Comparisons of elderly and control patient groups using chi 2 analysis and Mann-Whitney U test (alpha = 0.05). RESULTS: Four hundred eighteen elderly patients and 175 nonelderly controls were entered into the study. The elderly were more likely to arrive by ambulance (35% versus 11%; P less than .00001). More elderly than controls presented with conditions of either high or intermediate urgency (78% versus 61%; P less than .0003). The elderly more frequently presented with comorbid diseases (94% versus 63%; P less than .00001). Other findings for the elderly included a longer mean stay in the ED (185 versus 155 minutes; P less than .003), higher laboratory (78% versus 53%; P less than .00001) and radiology (77% versus 52%; P less than .00001) test rates, higher mean overall care charges ($471 versus $344; P less than .00001), and an admission rate (47% versus 19%; P less than .00001) twice that of younger adults. CONCLUSION: Resource use and charges associated with emergency care are higher for the elderly than for younger patients. Increases in emergency resources and personnel or improvement in efficiency will be needed to maintain emergency care at present levels as the US population continues to grow and age.

Adult↗
PubMed1992

Geriatric patient emergency visits. Part II: Perceptions of visits by geriatric and younger patients.

OBJECTIVES: To compare group perceptions of reasons for emergency department care, ED use patterns, and the effect of illness on self-care ability for elderly and younger adult patients. DESIGN: Patient survey. SETTING: Six geographically distinct US hospital EDs. PARTICIPANTS: From each site, a stratified sample (approximately 7:3) of elderly (65 years and older) and nonelderly (21 to 64 years old) control ED patients treated during the same time period was contacted. METHODS: Three hundred ninety-nine elderly patients and 172 adult controls were interviewed using a structured survey instrument. Groups were compared using chi 2 analysis and the Mann-Whitney U test. RESULTS: Both the elderly and the control patients (49% versus 38%) commonly stated that the most important reason for coming to the ED was because they were "too sick to wait for an office visit." Of patients with a regular physician, both groups often were referred to the ED by their primary care provider (35% versus 26%). While the elderly had more visits to their primary care provider (3.3 versus 2.9 visits; P less than .00001), there was no difference in the number of ED visits (1.5 versus 1.6 visits) during the preceding six months. Of those released from the ED, more elderly noted deterioration in their ability to care for themselves as a result of their illness (21% versus 11%; P less than .03). CONCLUSION: The elderly use the ED for reasons similar to those for younger adults. Often they feel too ill to wait for an office visit or are referred in by their primary care provider. Elderly patients more commonly have difficulty with self care after release home, and emergency physicians must plan accordingly.

Adult↗
PubMed1980

Some demographic and diagnostic characteristics of a geriatric population in a state geriatric facility.

Data are presented on some of the chief characteristics of a sample of 276 patients (152 women and 124 men) in a long-term state psychiatry facility, who had previously undergone intensive psychiatric treatment. For the women the average age ws 81.6 years, and for the men 75.8 years. The women had slightly more schizophrenia, manic depressive illnesses and cerebrovascular syndromes. The men had distinctly more CNS syphilis and alcoholic dementia. Initially, patients with schizophrenia had been admitted at ages ranging from 15 to 99 years, and those with manic depressive illness at ages ranging from 20 to 70 years. For cerebrovascular syndromes, admissions were concentrated in the age range of 70-90 for women and 65-85 for men. For CNS syphilis, the admissions (for men) were concentrated in the age range of 50-70, and for alcoholic dementia in the age range of 60-80. Length of stay was extremely long for schizophrenic and manic depressive illness and relatively short for cerebrovascular syndromes. However, for the majority of the cerebrovascular patients, the length of stay was at least five years for the men and at least ten years for the women.

Adolescent↗
PubMed1984

Geriatric psychiatry in the emergency department, II: Evaluation and treatment of geriatric and nongeriatric admissions.

The records of a hospital psychiatric emergency department were reviewed for elderly and middle-aged patients who were diagnosed with organic brain syndrome (OBS) or psychiatric disorder. These records were then compared with those of elderly patients from the medical emergency department. While elderly medical patients received routine physical evaluations and laboratory testing, elderly psychiatric patients with behavioral symptoms were often referred to psychiatry before they received tests necessary to differentiate physical disorders from functional psychiatric disorders. When tests were administered to psychiatric patients, many abnormal results were apparent, indicating the possible presence of physical disease. It is recommended that all elderly patients with psychiatric symptoms undergo adequate medical evaluations to screen for physical causes of the psychiatric symptoms.

Aged↗